Our Ability Jobs

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Position Summary

This position is responsible for the processing of Medicare members premium refunds accurately and timely utilizing SSI/Aetna policy guidelines and plan systems in accordance with key performance metrics. The primary focus will be on the PDP/SSI line of business, but not limited to that as the team is also responsible for MAPD/Aetna work.

Key responsibilities will include processing member refunds, providing trending and other pertinent feedback to leadership, reviewing Policy and Procedures for accuracy, maintaining expected production and quality standards and the ability to work in multiple systems (FACETS, EMA, MP (MNG) etc.)

Required Qualifications

• Knowledge of the SSI systems (FACETS, EMA) as well as the Aetna systems (Aetna systems is a plus)

• Demonstrates working knowledge of standard billing practices.

• Ability to analyze financial information and reports.

• Researches, resolves, and responds to premium refund related inquiries

• Ability to provides trends and “root cause” analysis and process improvement opportunities to the management team.

• Helps the leadership team create, review and prepare for various audits. (SOX, CMS, Internal)

• Must be a team player

• Must have strong verbal and written communication skills

• Must be able to work independently

Preferred Qualifications

• Ability to prioritize tasks/work effectively.

• Strong verbal and written communication skills.

• Well organized. Math and accounting skills.

• Problem solving skills.

• Attention to detail and accuracy.

• Proficient in Microsoft Word, PowerPoint, Excel, Outlook and Teams

• Financial experience a plus

Education

High School Diploma or equivalent

Pay Range

The typical pay range for this role is:

$17.00 - $29.88

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 04/12/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.